Topical steroids

Also known as topical steroids.

Steroid creams and ointments (topical steroids) are used to reduce inflammation and itchiness in skin conditions such as eczema or dermatitis.

What are topical steroids?

Topical steroids are used to reduce inflammation and itchiness in skin conditions such as eczema, dermatitis or psoriasis.

  • They are also known as topical corticosteroids, glucocorticosteroids and cortisone.
  • Topical steroids work by reducing inflammation and the amount of collagen in your skin, which may ease symptoms such as itchiness and redness.
  • They are applied to your skin in the form of creams, ointments, lotions or solutions. 
  • For skin conditions associated with dryness, such as eczema, other treatments such as emollients and moisturisers may also be needed.
  • If an emollient and a topical corticosteroid are prescribed at the same time, one should be applied at least 30 minutes before the other. The order of application is not important.  

Different types of topical steroids

There are many types and brands of topical steroids available in New Zealand that vary in potency from mild to very potent. Read more about the different types of topical steroids and formulations.

How should I apply a topical steroid?

  • how to apply steroid creamUse topical steroids as instructed by your doctor, who will explain where, how frequently and for how long to apply the medication.
  • Creams or ointments are rubbed gently into the affected skin until they have disappeared.
  • The amount of topical steroid that you should apply is commonly measured by fingertip units (FTUs)
  • One FTU is the amount of topical steroid that is squeezed out from a standard tube along an adult's fingertip (the distance from the tip of the adult index finger to the first crease). This should cover an area equivalent to your two palms (as shown in the image).
  • View a useful video on FTUs in the resources column on this page. Read more about fingertip units .
  • In some instances, your doctor may ask you to use plastic to cover treated areas. Covering the treated area with plastic after applying a topical steroid increases the absorption of the steroid, but may also increase side effects. Therefore it is usually recommended only in areas of very thick skin such as the palms of your hand and soles of your feet.  

Precautions before using topical steroids

  • Are you are taking or using any other medicines? This includes any other creams or medicated soaps you are using that are available to buy without a prescription.
  • Have you ever had an allergic reaction to a medicine?

If so, it’s important that you tell your doctor or pharmacist before you start using topical steroids. Sometimes a medicine isn’t suitable for a person with certain conditions or it can only be used with extra care.

What are the side effects of topical steroids?

Like all medicines, topical steroids can cause side effects, although not everyone gets them. 

Side effects What should I do?
  • Burning or stinging feeling 
  • This may happen when you first start applying the treatment.
  • It usually improves as your skin gets used to the treatment.
  • Tell your doctor if this feeling continues.
  • Thinning of the skin
  • This tends to occur with the potent or very potent topical steroids, if a plastic covering is used or if steroids are used often or long term.
  • It is less likely to occur with the mild or moderate topical steroids or if sterioids are only used for a short course.
  • If it does occur, it often goes away when the treatment is stopped.
  • Tell your doctor.
  • Permanent stretch marks
  • Bruising
  • Discolouration
  • Thin spidery veins
  • These tend to occur with long-term use of topical steroids.
  • Tell your doctor if troublesome.
  • May cause or worsen other skin conditions such as acne
  • Tell your doctor.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product

Learn more

Topical steroids DermNet NZ
Topical corticosteroids available in New Zealand (prescription only) BPAC, NZ, 2009
Topical steroids for eczema Patient Info, UK

Useful resources for healthcare professionals

Topical corticosteroids NZ Formulary
Steroid rebound – a topical issue Medsafe, NZ, 2013
Topical corticosteroids – face facts Medsafe, NZ, 2015
Treating childhood eczema – a topical solution for a topical problem BPAC, NZ, 2015

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 27 Sep 2018